Surfers' Ear

24 Apr 2012 0 Share

Words by Dr Chris Foxton

It is well known amongst the surfing community that surfers suffer from ear problems. Despite this commonly held belief there is little scientific research or proof about the types of ear problems surfers get, or how frequently they occur.

Below are some quick bits of information explaining three common ear conditions that surfers often seem to suffer from. This is meant to be a quick and simple guide with simple diagrams demonstrating the conditions. It is not meant to replace a proper consultation with your Doctor.


The Normal Healthy Ear

A normal ear should let you hear normally, be free from pain, infection and discharge and crucially for surfers should be waterproof. A healthy ear should be quite happy to be submerged in water with no ill effects when you surface.

The ear is best divided into the outer ear, the middle ear and the inner ear.


The outer ear consists of the pinna ( the flappy bit you can grab hold of) and the external auditory canal which is the canal you can stick your finger in leading down to the ear drum.

The middle ear is an air filled space behind the ear drum that contains the bones of hearing (Mallues, Incus and Stapes) as well as some important nerves to the face and tongue. The middle ear space is separated from the outside world and the ocean by the ear drum and hence should be waterproof. This space is connected to the back of the nose and throat by the Eustachian tube to allow equalisation of pressure when diving etc… hence holding your nose and puffing your cheeks out will ‘pop’ (equalise) your ears.

The inner ear consists of the cochlea which is the organ of hearing, and the semicircular canals which is the organ of balance and allows you to judge head movements. Both of these hearing and balance organs are buried deep within thick bone in the skull.


Ear Problem 1 - Otitis Externa Infection

This is a common type of ear infection after surfing. It can be caused by surfing in dirty water or because water has stagnated in the ear and allowed bacteria to grow. It is also commonly caused by ear bud use. It is an infection of the skin lining the external ear canal and does not affect the ear drum. It is very painful and may result in foul smelling discharge from the ear. Hearing is often muffled as the skin lining the canal swells so much sound is blocked from travelling down to the ear drum.

The first line of treatment is antibiotic ear drops that will bathe the infected skin and having the ear cleaned of pus and dead skin under a microscope by a specialist. Severe cases may need to be treated in hospital with intravenous antibiotics.


Ear Problem 2 - Burst Ear Drum

A burst ear drum (also known as a ruptured tympanic membrane) can occur from either infection in the middle ear space or by trauma to the ear drum. In surfers this can be caused by a particularly heavy wave landing directly onto the side of the head. Initially this tends to be painful and then quickly settles down and is usually accompanied by a bloody discharge from the ear.

Most people will notice that their hearing suddenly goes down but that they are not completely deaf in this ear. This is because the ear drum now has a hole in and cannot transmit sound as well as it did before.

Most burst ear drums will heal themselves in 6-12 weeks and water must be kept strictly out of the ear to allow the delicate cells to reform and heal to a normal-strength, waterproof ear drum. This can be frustrating for surfers.

If the ear drum does not heal itself then a specialist can perform surgery to patch it. This operation is called a myringoplasty and the patient needs to be put to sleep with a general anaesthetic and have the ear drum lifted up and patched with a piece of skin from behind the ear. The ear needs to be kept dry for at least 6 weeks afterwards while it heals. 


Ear Problem 3 - Exostoses / Surfer’s Ear

Surfer’s ear is often seen in people who surf a lot in cold water. For some reason the cold water causes bone near the external ear canal to grow in hillocks and causes narrowing of the canal. This narrowing of the external ear canal means that water and dead skin gets trapped behind the narrow points and this water then stagnates and causes infection.

Surfers with this condition often complain of a sensation of the water being trapped in their ear which they cannot clear by shaking or tilting their head,  followed by repeated ear infections.

The first simple treatment for surfer’s ear is to try and prevent the problem by avoiding cold water exposure using ear plugs.

Once the boney overgrowth is present it does not go away, and in severe cases surgery is required to lift the skin off the boney overgrowths and drill away the excess bone. This is a little like re-boring a pipe. Once surgery is performed the ear needs to be kept dry for some weeks/months to allow the skin to heal again and leave an infection free, waterproof ear.


Remember, there are many other conditions which occur in the ear and the three above are just an example of some of the more common ones. Your doctor or specialist should always see you individually before a diagnosis is made.

Many thanks for taking the time to read this article and for filling out the anonymous medical survey below about ear problems in surfers. By filling this out you will contribute to our understanding about ear pathology in people who surf around the world. Please feel free to pass on the link to other surfers. In due course once the research is completed it will be submitted for publication in a reputable medical journal.

- Dr Chris Foxton


Get involved

As an Ear, Nose and Throat Doctor and keen surfer Dr. Foxton is conducting medical research to the type and frequency of ear problems surfers experience.

If you’d like to help, please take the time to complete this 2-3 minute online survey about your ears and surfing. This is strictly confidential and you must not leave your name.


Tags: medical , health , ear (create Alert from these tags)

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